Provider Demographics
NPI:1881814986
Name:NEWSOME REHABILITATION CENTER
Entity Type:Organization
Organization Name:NEWSOME REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AND COLLECTIONS SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HATZL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-744-4770
Mailing Address - Street 1:2848 PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-1167
Mailing Address - Country:US
Mailing Address - Phone:815-436-1444
Mailing Address - Fax:815-436-9814
Practice Address - Street 1:2848 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-1167
Practice Address - Country:US
Practice Address - Phone:815-436-1444
Practice Address - Fax:815-436-9814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========OtherTAX ID
IL146636Medicare ID - Type UnspecifiedMEDICARE NUMBER